Low Back Pain

Low Back Pain

Definition

Low back pain is an ache or discomfort in the area of the lower part of the back and spinal column. The lower spinal column consists of many small bones that surround and protect the spinal cord and nerves. Low back pain is very common, affecting most adults at some point in their lives.

Symptoms

Pain is usually localized in the low back. It gets worse with back motion, sitting, standing, bending, and twisting. If a nerve is irritated, the pain may extend into the buttock or leg on the affected side, and muscle weakness or numbness may be present. It usually gets better with rest, and there is good bowel and bladder control.

More serious symptoms associated with back pain that may require immediate medical attention include:

Pain that is severe or that has gotten dramatically worse

Progressive weakness in a leg or foot

Difficulty walking, standing, or moving

Numbness in the genital or rectal area

Loss of bowel or bladder control

Difficulty with urination

Fever, unexplained weight loss, or other signs of illness

Pain that awakes you from sleep at night

Pain that doesn't improve or worsens with rest (even at night) may be an indication of a more serious disease.

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. In particular, the doctor will examine your back, hips, and legs and usually will test for strength, flexibility, sensation, and reflexes.

Other tests include:

X-rays]]>
—a test that uses radiation to take a picture of structures inside the body, especially bones. This test is usually done if you are over 50 years old or have persistent symptoms for more than a week. This test has its limitations in that it does not show herniated discs or spinal stenosis

]]>CT scan]]>
—a type of x-ray that uses a computer to make pictures of structures inside the body. This test provides a good picture of the vertebrae and the spinal canal. This test is done when there are persistent symptoms.

]]>MRI scan]]>
—a test that uses magnetic waves to make pictures of structures inside the body and shows the intervertebral discs and any abnormality of the discs. This test is done when there are persistent symptoms.

It's important to keep in mind that imaging tests, like CT or MRI scan, may not be helpful immediately after a back injury.

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Treatment

Treatment options include:

Bed Rest

Short-term bed rest is not generally recommended in normal individuals. It is only recommended in those with severe debilitating back pain, and for not more that 1-2 days. Movement helps in cases of muscle spasm and to maintain muscle strength.

Medication

Muscle relaxants for muscle spasm—These medications are not used in cases where you need to be alert, such as driving or operating machinery.

Cortisone injections

Antidepressants are also sometimes prescribed for low back pain. While these medications may be effective for depression, there is little evidence they effectively relief chronic low back pain, whether patients are depressed or not.

Physical Therapy

Hot or cold packs

Stretching and strengthening exercises for back and abdominal muscles

Education about how to deal with back problems

]]>Massage]]>
—Massage might be helpful especially if it is combined with education and exercise.

Ultrasound treatments or electrical stimulation

Your doctor may recommend that you restrict activities for 3-6 weeks, then resume activities as soon as possible.

Alternative Medicine

Surgery

Only a small number of patients need surgery. It may be needed if nerve problems develop or other treatments fail to provide relief. Common procedures are
]]>diskectomy]]>
,
]]>laminectomy]]>
, and
]]>spinal fusion]]>
.

Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a
medical condition.